Blood Supply to the Head and Neck Part 1 GN PDF

Blood Supply to the Head and Neck – Arterial Supply Josh Hudson Oral and Dental Sciences GDC Learning Outcomes 1.1.5 Describe relevant and appropriate dental, oral, craniofacial and general anatomy and explain their application to patient management Intended learning outcomes By the end of thi...

Blood Supply to the Head and Neck – Arterial Supply Josh Hudson Oral and Dental Sciences GDC Learning Outcomes 1.1.5 Describe relevant and appropriate dental, oral, craniofacial and general anatomy and explain their application to patient management Intended learning outcomes By the end of this session you will be able to.. Name the major arteries in the head and neck Explain what areas these main arteries supply Describe the important rela=ons and branches of the common caro=d artery Describe the important rela=ons and branches of the external caro=d artery Why do I need to know this? Why do I need to know this? We are working in a very complicated area, oBen puCng sharp things into it! Need to be aware of the blood supply to the diEerent areas we are working Need to know loca=on of important vessels to avoid them Need to know what is considered ‘normal’ to iden=fy devia=ons from this How is best to learn this? How is best to learn this? Unfortunately, as with a lot of anatomy this is a challenge! If you engage with the content and use resources available to you it should not put you to sleep. Ul=mately comes down to three things 1) Take the =me to really look at this a memorise 2) Learn pneumonic which are of relevance to you! 3) Use resources Where do I start?  Wikipedia. (2022) Aortic Arch [Photograph]. Available from: https://en.wikipedia.org/wiki/Aortic_arch [Accessed: 17th August 2022] Lets start with the basics.. So to keep things simple, lets start with the basics. Where does the main arterial blood supply to the head and neck originate from? We need to consider the arch of the aorta which gives rise to the 3 main vessels; Artery brachiocephalic, leG common caroHd and & right subclavian. LEFT Lets start with the basics.. This may be confusing but this gives a broad overview of where the blood supply goes from here.. The brachiocephalic gives rise to the right subclavian as well as the right common caroHd arteries. The right subclavian gives rise to the right vertebral. The right common caroHd forms the internal and external caroHd. Lets start with the basics.. The arch of the aorta gives rise to the leG subclavian as well as the leG common caroHd arteries directly. The leG subclavian gives rise to the leG vertebral. The leG common caroHd gives rise to the the internal and external caroHd, the same as on the right. The right and leG vertebral arteries supply blood to the spinal cord and vertebral muscles.  Wikipedia. (2022) Aortic Arch [Photograph]. Available from: https://en.wikipedia.org/wiki/Aortic_arch [Accessed: 17th August 2022] What next? First we will consider the common caro=d arteries. The leG common caroHd comes directly from the arch of the aorta and the right common caroHd comes from the brachiocephalic artery.  Kenhub. (2022) Common Carotid [Photograph]. Available from: https://www.kenhub.com/en/library/anatomy/common-carotid-artery [Accessed: 17th August 2022] Where next? These right and leB common caro=d arteries go on to supply both sides of the head and neck in a mirror image. Both the right and leG common caroHd arteries split into two main branches Internal caroHd artery External caroHd artery  Kenhub. (2022) Common Carotid [Photograph]. Available from: https://www.kenhub.com/en/library/anatomy/common-carotid-artery [Accessed: 17th August 2022] Where next? As shown in this diagram, the internal caroHd artery goes deep within the face, through the caro=d canal in the base of the skull (behind the eyes) and into the cranial cavity. Ul=mately this supplies the brain, eyes, forehead and part of the nose with the leB and right versions supplying each side.  Kenhub. (2022) Common Carotid [Photograph]. Available from: https://www.kenhub.com/en/library/anatomy/common-carotid-artery [Accessed: 17th August 2022] Where next? As shown in this diagram, the external caroHd artery remains more superUcial and branches to supply many superUcial elements of the head and neck. Ul=mately this supplies the neck, face, scalp, tongue and maxilla Where next? Te Su m p p e o r f ral icial Po ricu As shown in this diagram, the external Au ste lar caroHd artery splits into 8 main rio r branches. These are the superior thyroid, ascending pharyngeal, Maxillary lingual, facial, occipital, posterior O cc l auricular, superLcial temporal and Facia ip ita l maxillary. As aryng Lingual Ph ce nd eal ior ing er These then go on to supply the various Sup id ro structures within the head and will be Thy discussed shortly. External Carotid How is best to learn this? How to remember this? The easiest way to learn this is through a pneumonic. The more random the beWer! (I can s=ll remember mine from university but not suitable to share..) A more sensible op=on is shown on the next slide How to remember this? S = Superior Thyroid = She A = Ascending Pharyngeal = Always L = Lingual = Likes F = Facial = Friends O = Occipital = Over P = Posterior Auricular = Papa S = SuperLcial Temporal = Sister M = Maxillary = Mama That’s Lne but what do these branches supply? What do these branches supply? These branches supply a whole host of areas in the head and neck. Some of these are more important than others. Detailed on the next few slides are the main dentally relevant supply of each (these lists are not exhaus=ve). Superior Thyroid = Thyroid gland, some muscles of the neck and larynx Ascending Pharyngeal = Pharynx, soB palate and prevertebral muscles What do these branches supply? Dorsal Lingual Artery Deep Lingual Artery Lingual Artery The lingual artery supplies important structures so we will cover this in a liWle more detail. It further splits into; 1) Sublingual 2) Dorsal lingual 3) Deep lingual Sublingual Artery Lingual Artery What do these branches supply? Dorsal Dorsal Lingual = This supplies the base Deep Lingual Artery Lingual of the tongue, palatoglossal arch, Artery tonsils, soB palate and epigloCs Sublingual = Supplies the sublingual gland, muscles in the ]oor of the mouth and buccal and gingival mucous membranes Sublingual Artery Lingual Artery What do these branches supply? Dorsal Deep Lingual = This is the terminal Deep Lingual Artery Lingual part of the lingual artery and gives Artery blood supply to the body of the tongue KEY LEARNING POINTS The lingual artery supplies the tongue, sublingual gland and buccal/gingival Sublingual Artery mucous membranes Lingual Artery What do these branches supply? Facial Artery The facial artery is another vessel that supplies important structures. This branches mul=ple =mes to ul=mately supply the muscles and skin of the face and the submandibular gland.  Kenhub. (2022) Occipital Artery [Photograph]. Available from: https://www.kenhub.com/en/library/anatomy/occipital-artery [Accessed: 17th August 2022] What do these branches supply? Occipital Artery This artery supplies muscles in the posterior neck, skin of the neck and ear as well as the scalp in the occipital region.  Musculoskeletal Key. (2016) The Posterior Auricular Artery [Photograph]. Available from: https://musculoskeletalkey.com/the-posterior-auricular-artery/ [Accessed: 17th August 2022] What do these branches supply? Posterior Auricular Artery This artery supplies muscles in the posterior neck, skin over and around the ear and the ear structures. Posterior Auricular Artery  Kenhub. (2022) Superficial Temporal [Photograph]. Available from: https://www.kenhub.com/en/library/anatomy/superficial-temporal-artery [Accessed: 17th August 2022] What do these branches supply? SuperLcial Temporal Artery This artery supplies some of the skin and muscles of the scalp, paro=d gland and temporomandibular joint. This is one of the two terminal branches of the external caro=d along with the maxillary artery.  Wikipedia. (2022) Accessory Meningeal Artery [Photograph]. Available from: https://commons.wikimedia.org/wiki/File:Assessory_meningeal_artery.png [Accessed: 17th August 2022] What do these branches supply? Maxillary Artery The maxillary artery also supplies important structures so we will cover this in a liWle more detail. As can be seen from the image, this is a very complex vessel and there is no need to learn all of these branches!  Wikipedia. (2022) Accessory Meningeal Artery [Photograph]. Available from: https://commons.wikimedia.org/wiki/File:Assessory_meningeal_artery.png [Accessed: 17th August 2022] What do these branches supply? Maxillary Artery This ul=mately supplies blood to everywhere else. This includes the whole maxillofacial region including; the hard and soB =ssues of the maxilla, mandible, nasal cavity and deep facial areas. What do these branches supply? The Teeth Maxillary Artery Superior Alveolar Artery The maxillary teeth are Descending Palatine supplied by the maxillary Artery Inferior Alveolar artery. A branch of this is the Artery superior alveolar artery which splits into posterior, middle Internal Incisive Branch of Inferior Alveolar and anterior branches. These Carotid Artery Dental Branch Artery branches then go on to supply of Inferior Alveolar Mental Artery Artery External each of the maxillary teeth Common Carotid Artery Carotid Artery depending on their posi=on. What do these branches supply? The Teeth Maxillary Artery Superior Alveolar Artery The mandibular teeth are also Descending Palatine supplied by the maxillary Artery artery. A branch of this is the Inferior Alveolar Artery inferior alveolar artery which forms a dental branch, incisive Incisive Branch branch and the mental artery. Internal of Inferior Alveolar Carotid Artery Artery These branches then go on to Dental Branch of Inferior Alveolar Mental Artery supply each of the mandibular External Artery Common teeth depending on their Carotid Artery Carotid Artery posi=on. Summary The arterial supply to the head and neck is complicated Ul=mately need to be aware of two main bilateral vessels (internal/external caro=d) External caro=d gives rise to the blood supply of most of the mouth and face Key branches are; lingual, facial and maxillary branches for the areas we are working Need to have an awareness of other branches Find a pneumonic that works for you! Caveat Not everyone is the same and because of this, not all vessels join the same in every case. Due to this, when you undertake further reading you may Und some references may have things in a slightly diEerent order as there may be debate on what the most common presenta=on is. References Image credit; Wikipedia, Kenhub.com, anatomy.tv Resources; Kenhub.com – Invaluable resource for further informa=on Anatomy.tv – You all have access to this interac=ve anatomy package hWps://www.youtube.com/watch?v=kJf8wdJPZeQ